Blood Transfusions, Outcomes and Shock

A Beginner’s Guide to Vasoactive Drug use in Children with Septic Shock

Don't Forget the Bubbles

NOVEMBER 27, 2023

What is Shock? Shock is defined as a type of circulatory failure where lack of oxygen leads to dysfunction of vital organs. There are many types of shock which may affect children, and management is specific to the type of shock. The overall goal in managing any cause of shock is to restore oxygen delivery to the organs.

Shock

Shock Sepsis Fluid Resuscitation Resuscitation

Trauma Resuscitation Updates

RebelEM

MAY 25, 2023

I recently gave a talk on the initial management of trauma patients with hemorrhagic shock. Clinical Take Home Point: In patients with TBI and hypovolemic shock, target a SBP or MAP ≥90mmHg, but know this is based on limited evidence. vs SBP target <90mmHg which resulted in a mortality of 33.4% NEJM 1994. [2]

Resuscitation

Resuscitation Fluid Resuscitation Head Injuries Shock

Sickle Cell Disease Module

Don't Forget the Bubbles

JULY 5, 2023

Furthermore, educating both patients and their families is important in order to achieve good treatment compliance and better clinical outcomes. Be careful if the patient has received a recent blood transfusion since it may be misinterpreted as sickle cell trait instead of sickle cell disease. coli and Staphylococcus aureus.

Blood Transfusions

Blood Transfusions Stroke Dehydration Sepsis

Are we on the right TRACT?

Don't Forget the Bubbles

JANUARY 10, 2024

Transfusion Decisions in Severe Anaemia Reducing child mortality remains high on the global health agenda. Let’s take the humble blood transfusion – used in emergency departments across the globe and playing a key role in critical care. However, there is a huge variation in transfusion practice globally.

Blood Transfusions

Blood Transfusions Research Outcomes Hospitals

Vasopressor Nonresponse

Northwestern EM Blog

JANUARY 24, 2022

Written by: Elizabeth Stulpin, MD (NUEM ‘23) Edited by: Aaron Wibberly, MD (NUEM ‘22) Expert Commentary by : Joshua Zimmerman, MD (NUEM ‘17) Non-Response to Vasopressors Shock is defined as a state of cellular and tissue hypoxia resulting in end organ dysfunction. And for most forms, EM physicians are not typically shocked by shock.

Anaphylaxis

Anaphylaxis Shock Sepsis Resuscitation

ToxCard: Iron

EMDocs

DECEMBER 6, 2024

Stage 3 (timing variable) Shock 1 : Can occur within hours for massive ingestion, but may occur over a longer time course. 6 Severe toxicity and shock are typically seen with serum iron concentrations above 500 g/dL and serum iron concentrations above 1000 g/dL are associated with significant mortality. Antiemetics as needed.

Poisoning

Poisoning Fluid Resuscitation Seizures Resuscitation

Episode 21- Updates and Controversies in the Early Management of Sepsis and Septic Shock

EB Medicine

OCTOBER 1, 2018

This month, we’ll be talking Updates and Controversies in the Early Management of Sepsis and Septic Shock. And sepsis-3 redefined septic shock as “hypotension not responsive to fluid resuscitation” with the added requirement of vasopressors to maintain a MAP greater than or equal to 65 and with a lactate > 2. That’s where we’re at.

Sepsis

Sepsis Shock Fluid Resuscitation Hospitals

Neonatal Hypotension

Don't Forget the Bubbles

NOVEMBER 18, 2024

Research and guidelines from Australian centres, like those published by the Australian and New Zealand Neonatal Network (ANZNN), emphasize early detection and management to improve outcomes. If anaemia is confirmed, a blood transfusion may be necessary to restore adequate circulatory volume and improve oxygen-carrying capacity.

Sepsis

Sepsis Shock Hyperthermia / Hypothermia Administration

TEG-Guided Resuscitation of Patients with Cirrhosis and Non-Variceal Bleeding

RebelEM

SEPTEMBER 26, 2022

Randomized study design Blind adjudication of transfusion reaction outcomes Follow-up was complete. The primary outcome was disease-oriented The enrolled cohort appears to be a convenience sample Sealed envelopes are a weak type of allocation and prone to error and manipulation. Significant coagulopathy: INR > 1.8

Resuscitation

Resuscitation Blood Transfusions Outcomes Hospitals

emDOCs Revamp – Acute Chest Syndrome

EMDocs

JUNE 27, 2024

His medical history is significant for three prior admissions for vaso-occlusive crises that have responded well to appropriate therapy, including pain control with NSAIDs and opioids, blood transfusions, antibiotics, and intravenous (IV) crystalloids. Pediatr Blood Cancer. Triage vital signs include BP 127/81, HR 119, T 102.9

Pediatrics

Pediatrics EMS Dehydration Hospitals

Journal Club - Tranexamic Acid in Trauma

Downeast Emergency Medicine

APRIL 26, 2021

4] We also know that severe TBI is commonly associated with the development of intracranial hemorrhage where the presence and volume of blood are associated with increased mortality and poor outcomes.[5] Association between prehospital tranexamic acid administration and outcomes of severe traumatic brain injury. JAMA Neurol.

Head Injuries

Head Injuries Administration Outcomes Seizures

Episode 26 – Blunt Cardiac Injury: Emergency Department Diagnosis and Management (Trauma CME)

EB Medicine

MARCH 1, 2019

Consider valvular injury in any patient who appears to be in cardiogenic shock, has hypotension without obvious hemorrhage, or has pulmonary edema. In those with severe injury, you may note refractory hypotension secondary to cardiogenic shock. The latter also recommend ED thoracotomy in those with refractory shock.

Emergency Department

Emergency Department EKG/ECG Operations Fractures

Unstable Pelvic Trauma Patient: ED Presentations, Evaluation, and Management

EMDocs

JUNE 3, 2023

4 Patients with pelvic fractures are considered unstable when systolic blood pressure < 90mmHg and heart rate >120bpm, or in those with dyspnea, altered mental status, or skin findings of shock. Management and outcomes of open pelvic fractures: An update. Lateral compression 2 pelvic fracture. Radiopaedia.org.

Fractures

Fractures Resuscitation Operations EMS

A guide to major haemorrhage management in paediatrics

Don't Forget the Bubbles

OCTOBER 28, 2024

These definitions include blood loss of 40 mL/kg over 24 hours, transfusion of ≥50% of total blood volume in 3 hours, transfusion of 100% of total blood volume in 24 hours, and bleeding with clinical signs of hypovolaemic shock that is unlikely to be controlled. What is the ‘diamond of death’?

Blood Transfusions

Blood Transfusions Hyperthermia / Hypothermia Shock Pediatrics

emDOCs Podcast – Episode 96: Lower GI Bleeding

EMDocs

MARCH 6, 2024

shock index > 1, evidence of poor systemic perfusion). There is no clear improvement with idarizucimab or andexanet alfa on patient-oriented outcomes. TXA: Several studies have found no benefit in patient-oriented outcomes with TXA in patients with significant lower GI bleeding. If severe bleeding, administer PCC.

Blood Transfusions

Blood Transfusions Outcomes Resuscitation Radiology

Diagnostics: GI Bleeding

Taming the SRU

OCTOBER 25, 2023

Ultimately, patients with variceal bleeding require endoscopic variceal ligation (EVL) but it is important to understand what therapies should be initiated promptly in the ED to improve overall outcomes.

Blood Transfusions

Blood Transfusions Hospitals Stroke Anaphylaxis